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Date: Thu, 6 Apr 1995 14:56:26 -0400 (EDT)
Subject: Naval Service Medical News (NSMN) 95-14
R 050246Z APR 95 ZYB
FM BUMED WASHINGTON DC// 00//
SUBJ/PUBLIC AFFAIRS-NAVAL SERVICE MEDICAL NEWS (NSMN) (95-14)//
POC/P.C. BISHOP/CAPT/MED-OOP (PUBLIC AFFAIRS) /-/TEL: (202)
RMKS/1. THIS SERVICE IS FOR GENERAL DISTRIBUTION OF INFORMATION
AND NEWS OF INTEREST TO NAVY AND MARINE CORPS MEMBERS, CIVILIAN
EMPLOYEES, FAMILY MEMBERS AND RETIRED BENEFICIARIES OF NAVY
MEDICINE. MAXIMUM AND TIMELY REDISTRIBUTION OR FURTHER
REPRODUCTION AND USE BY ACTION ADDRESSEES IS ENCOURAGED. THIS
MESSAGE HAS BEEN COORDINATED WITH THE COMMANDANT OF THE MARINE
CORPS (CMC) . THE COMMANDANT HAS AUTHORIZED TRANSMISSION TO
MARINE CORPS ACTIVITIES.
2. HEADLINES AND GENERAL INTEREST STORIES THIS WEEK:
(950114) -Fleet Hospital 15 Personnel Part of Kernel Blitz
(950115) -Navy Corpsman Renders Assistance in Malaysia
(950116) -A Team Effort at Naval Hospital Guantanamo Bay
(950117) -Peleliu Dentist Praises Navy Experiences
(950118) -Navy Medical Department People Involved in Operations
(950119) -HEALTHWATCH: HIV — What You Don't Know Could Kill You
HEADLINE: Fleet Hospital 15 Personnel Part of Kernel Blitz
NAVHOSP Pensacola, FL (NSMN) — Seventy-eight personnel from
Naval Hospital Pensacola, and its Branch Medical Clinics at Naval
Air Station Pensacola, Naval Technical Training Center Corry
Station and NAS Whiting Field, FL, departed 2 April for Camp
Pendleton, CA, in support of the largest medical training
exercise ever conducted — Kernel Blitz '95.
The Pensacola group made up the largest numbers of Navy
Medical personnel headed to the West Coast to set up a field
hospital on the Marine Corps base. They were joined by more than
200 other personnel from 13 commands and clinics to form Fleet
Fleet Hospital 15 is made up of personnel from Naval
Hospitals Jacksonville, FL; Charleston and Beaufort, SC;
Millington, TN; Corpus Christi, TX; and Newport, RI; and Naval
Medical Center Portsmouth, VA. Other FH15 personnel came from
Naval Medical Clinic Key West, FL; Branch Medical Clinic Kings
Bay, GA; Naval Medical Clinic New Orleans; and Branch Dental
Clinics at Whiting Field, Milton and Jacksonville, FL.
Kernel Blitz '95 is a partially simulated naval amphibious
assault which has been ongoing since 27 May off the coast of San
Diego. It is under the operational guidance of Commander, U.S.
Third Fleet .
Fleet Hospital 15, the only non-West Coast unit involved in
Kernel Blitz, is under the command of a Naval Hospital Pensacola
family practice physician, CAPT James H. Walker, MC. Earlier
this week, FH15 set up a 50-bed field hospital in anticipation of
200 "casualties" from the Kernel Blitz amphibious assault
The field hospital is comprised of four operating rooms and
three wards. The wards were to be operational for 12 continuous
hours — twice as long as normal during fleet hospital training
evolutions . Fleet Hospital 15 also tested some of Navy
medicine's high technology, such as teleradiology, which allows
the unit to send X-rays via satellite to a military hospital
where radiologists there are able to assist those at the field
hospital in making the most accurate diagnoses for patient
Fleet Hospital 15 will complete training, and be returning
home, 8 April .
Story by Rod Duren
HEADLINE: Navy Corpsman Renders Assistance in Malaysia
USS Jarrett (NSMN) — Four sailors from USS Jarrett (FFG 33)
— HN Christopher O' Sullivan, SN Matthew Rogers, SN Bradley
Taylor and GMMl Michael Grogan — rendered assistance to two
people involved in an automobile accident on 21 March near Lumat,
Malaysia. The victims were believed to be Malaysian nationals .
Jarrett sailors on liberty were traveling in a taxi when
they came upon the scene of a head-on automobile collision.
O' Sullivan observed one of the victims sitting on the ground and
the other walking aimlessly around the vehicles. It appeared the
victims were in need of medical attention. The Jarrett Sailors
had the driver stop the taxi . They debarked and began rendering
Police officers were already at the scene. Grogan assisted
them with rerouting traffic around the scene of the accident;
Taylor and Rogers assisted with crowd control.
While awaiting a local medical response team, the police
provided O' Sullivan with surgical gloves and allowed him to
inspect the victims . The corpsman performed a head-to-toe
assessment on both victims and determined that no head or neck
injuries had been sustained. The ambulatory victim had sustained
a small cut and a large bruise on his forehead. The second
victim, who was sitting beside his vehicle, had sustained several
lacerations on his right forearm and large bruises on his chest,
possibly a fractured sternum and some bruised or fractured ribs.
O' Sullivan used a towel found on the front seat of the
victim's car as a bandage to help stop the bleeding, which
stabilized the victim. Shortly thereafter, the ambulance arrived
and paramedics attended to the accident victims, who were loaded
into the ambulance and taken away. When the ambulance departed
the police began to secure the scene and Jarrett ' s good
Samaritans continued on with their day of liberty in Malaysia.
Story by JOCS(SW) Bob Herskovitz, COMNAVSURFPAC
HEADLINE: A Team Effort at Naval Hospital Guantanamo Bay
USNH Guantanamo Bay, Cuba (NSMN) — While U.S. Naval
Hospital Guantanamo Bay is technically not a part of Command
Joint Task Force 160 (CJTF 160), it supports the CJTF 160 mission
by providing outpatient and inpatient health care services to
Cuban and Haitian migrants .
An example of this joint effort occurred on 27 February
1995. At approximately 1700, a Cuban migrant was transported in
serious condition to the naval hospital from the Sixth Air
Transportable Hospital (6th ATH) . A presumptive diagnosis of
bacterial meningitis had been made by Air Force medical staff
based on signs /symptoms and preliminary laboratory results. Upon
arrival, naval hospital medical staff quickly reassessed the
patient ' s status and instituted procedures to stabilize and treat
the patient .
The admitting diagnosis remained bacterial meningitis . As
additional diagnostic tests were being collected, emergency room
staff notified the command' s environmental health officer (EHO) ,
in accordance with established Disease Alert Reporting
Procedures . This rapid notification process was developed and
established shortly after the initial arrival of Haitian migrants
in June 1994, as an outbreak of any infectious disease in the
camps could have a potentially rapid and detrimental impact on
other exposed migrants, camp personnel and health care providers.
Upon notification, the EHO reported to the emergency room
and assisted the ER staff in collecting as much information
regarding the patient and illness as possible. With this
material, a tentative plan of action was formulated to identify
contacts — migrants , JTF and hospital personnel — and their
vaccination status, and identification through testing the
causative organism. Due to the seriousness of the patient's
condition, the decision to medically evacuate the patient was
made and procedures to schedule a medevac flight were initiated.
Throughout the night, the patient remained stable, but was
At 0700 on 28 February 1995, the patient was transported to
the Leeward air terminal. A C-9 aircraft was standing by to
transport the patient and a medical team to a hospital in Miami .
At approximately this same time, results from CSF cultures
definitively indicated that the patient had Pneumococcal
meningitis . Members of the JTF 160 Public Health Team were
notified so that migrants and other personnel who may be
predisposed to Pneumococcal bacteria could be identified and
monitored. Based on this information, further preventive
actions, such as vaccination and prophylactic treatment of the
general population, were not considered necessary.
The entire evolution from notification to final action was
approximately 14 hours and is a prime example of the "joint"
elements of U.S. Naval Hospital Guantanamo Bay, the Air Force's
6th ATH, and JTF medical staff working in concert .
Story by LT M.J. Walsh, MSC, and ENS C.H. Henry, MSC
HEADLINE: Peleliu Dentist Praises Navy Experiences
USS Peleliu (NSMN) — "The Navy is an excellent way for a
dental school graduate to gain experience and additional
professional and technical exposure without having to worry about
the business aspect of paying the bills of a private practice, "
said LT Michael Mingle, DC, the dental officer aboard USS Peleliu
(LHA 5) .
He should know. After 18 months as a practicing dentist,
he's had the chance to do things that might take years of
experience in the civilian sector.
This is just the sort of "hands-on" experience the Navy
offers, and what Navy recruiters would like young dental students
in training at universities across the nation to know.
Last fall, deans of major medical and dental schools in the
Midwest — escorted by a group of Navy recruiters — came to San
Diego to tour naval facilities.
While here, they visited USS Peleliu to see the ship's
medical and dental capabilities . And while aboard Peleliu, a
University of Iowa recruiter recognized Mingle as one of her
success stories. The recruiter asked if he'd talk to other
The recruiting officer ended up with two Mingles coming East
— Mingle 's wife, Jennifer, is also a Navy dentist here in San
Diego. She is one of three dental officers aboard USS Dixon (AS
47) . The two met and married at the University of Iowa, which
they both attended under Navy scholarships.
"We were flown out to Iowa to spend the day at the
university. We spent most of the day talking with interested
individuals . Then that evening, we put on a small presentation
to explain the different scholarships available through the
Navy, " Mingle said. "I remember a few years ago when I was a
junior in dental school, I visited (National Naval Medical
Center) Bethesda (in Maryland) . It was a chance to see for
myself a little about what the Navy was really like. I hoped I
could bring some of that insight to the students in school now. "
One of the biggest advantages of accepting a Navy
scholarship is the experience. Mingle says.
"The more you see, the more you learn, and the Navy has
allowed me to see things I would normally not get much exposure
to, such as oral surgery. It's making me a better dentist. "
Story by LT Dave Blackwood, reprinted from The Compass, 13 JAN 95
HEADLINE: Navy Medical Department People Involved in Operations
BUMED Washington (NSMN) — The Navy Medical Department
continues to support the Navy and Marine Corps team through
deployments with the fleet and carrying out humanitarian
operations . Here is the latest update on where our medical
people are on assignment .
Medical forces currently on operational assignment are:
Operation Able Vigil
Medical/Dental augmentation personnel: 12
The Navy Medical Department is in full support of Operation
Able Vigil. Five Medical Corps, one Medical Service Corps, five
Nurse Corps officers and 40 hospital corpsmen are deployed to
U.S. Naval Hospital Guantanamo Bay, providing medical treatment
for approximately 23, 000 Haitian and Cuban migrants, in addition
to providing medical support to many afloat platforms.
Additionally, 21 personnel are assigned to CJTF 160, to include
six Medical Corps, four Nurse Corps and 11 corpsmen. They are
currently working with Air Force and Army medical personnel,
providing psychiatric services to the migrant population .
Operation Full Accounting
Navy Medical Corps officers and independent duty corpsmen are
supporting this operation by volunteering to serve tours ranging
from just under two weeks to two months. Eight missions remain
for FY 95. An IDC from Commander, Submarine Pacific, is in
country supporting current missions . The next scheduled missions
will be coming out of Pensacola, FL; Camp Lejeune, NC; and
Grot on, CT.
Individuals and components of mobile medical augmentation
readiness teams (MMARTs) support various exercises/operations as
required, bolstering the "organic" medical assets of the units
Surgical Team One from Naval Medical Center San Diego and
Surgical Team Six from Naval Hospital Charleston, SC, are on
routine 48-Hour Alert for any emergency situations .
Surgical Team Three from Naval Hospital Camp Pendleton, CA,
is providing medical support on board USS Belleau Wood (LHA 3) .
Surgical Team Five from Naval Medical Center Oakland, CA, is
providing medical support for Exercise Kernel Blitz on board USS
New Orleans (LPH 11) .
Fleet Surgical Teams are also deployed to provide additional
medical support where needed, as directed by the CINCs.
Miscellaneous OCONUS and Fleet Support
Providing TAD (temporary additional duty) support to nine fleet
platforms and seven OCONUS facilities are 18 Navy Medical
Department personnel: Six Medical Corps, two Medical Service
Corps, one Dental Corps and nine hospital corpsmen.
HEADLINE: HEALTHWATCH: HIV — What You Don't Know Could Kill You
BUMED Washington (NSMN) — The Human Immunodeficiency Virus
(HIV), which leads to the development of the Acquired
Immunodeficiency Syndrome (AIDS), continues to be a threat to
every man, woman and child. But, like other sexually transmitted
diseases, it is easily preventable . Who you are has nothing to
do with whether you are in danger of being infected. What
matters most is what you do, how you behave.
HIV infection is the leading cause of death among people 25-
44 years old. The World Health Organization estimates that each
day 5, 000 people become infected with HIV worldwide and predicts
that 40 million people could be infected by the year 2000.
Since the Navy began testing in 1985, more than 4, 000
Sailors and Marines have tested positive for HIV. As of 15 March
1995, 571 Navy and 82 Marine Corps HIV-positive personnel were
serving on active duty. If you are assigned to a deployable
unit, stationed overseas or are a health care provider, you are
tested yearly for HIV infection. If your unit is going overseas,
you must have had a test within the last 12 months. All Navy and
Marine Corps personnel are tested at the time of their regular
military physical (every five years under age 50; two years for
those over 50) .
It is important that every Sailor and Marine know the facts
regarding the transmission and prevention of HIV.
SUBHEAD: HIV is the Virus that Causes AIDS
HIV is passed from person to person through blood-to-blood
and sexual contact . AIDS is the inevitable result of HIV
infection. When a person has AIDS, the immune system becomes
damaged so that they can no longer fight off other infections.
These infections are usually fatal .
SUBHEAD: You Cannot "Catch" HIV Like You Do a Cold or Flu
Unlike other viruses, HIV does not spread by traveling
through the air. Even though HIV is sometimes found in small
amounts in saliva, the virus is not spread by saliva. HIV is
very fragile and dies quickly outside the body. Also, our skin
(without cuts or sores) helps prevent germs — including HIV —
from infecting us. For these and other reasons, HIV cannot be
spread by: shaking hands, hugging, coughing, sneezing, kissing;
nor from swimming pools, toilet seats, straws, spoons, dishes,
food, insects (including mosquitoes) or animals.
SUBHEAD: You Can Protect Yourself From Infection by HIV
When it comes to sexual behavior, abstinence is the only
foolproof way to avoid exposure to the virus. Postponing sex
until marriage or a long-term relationship with one partner are
also safer alternatives . If you are sexually active, reduce the
number of partners and have sex only with a partner who is not
infected, who has sex only with you, and who does not use needles
or syringes . If you are unsure about whether or not your sexual
partner is uninfected, protect yourself with a latex condom and a
spermicide such as nonoxynol-9. Never use needles or syringes
for any drug, including steroids, unless under a doctor's care.
SUBHEAD: Latex Condoms Can Help Protect You From HIV
Latex condoms can help protect you and your partner from
HIV. Birth control pills and diaphragms cannot . But you must
use the condoms the right way. And you must use them every time
you have sex (vaginal, anal or oral) from start to finish.
Condoms are not foolproof, because they can break, tear or slip
off. Experts recommend using only latex condoms for disease
SUBHEAD: Giving Blood is Not Risky Behavior
You cannot become infected by HIV or any other disease agent
by giving in the United States, because every piece of equipment
(needles, tubing, containers) used to draw your blood is sterile;
no piece of equipment has ever been used before; and all needles
are discarded properly after your blood is drawn. You cannot get
HIV by giving blood.
SUBHEAD: Can I Be Infected When I Receive Blood?
The risk of being infected with HIV from a blood transfusion
is very low. Since donor interviews for HIV risk began in 1983,
and HIV antibody testing began in 1985, the risk of
HIV-contaminated blood entering the blood supply has dropped
dramatically . Estimates of the chance of receiving an
HIV-infected transfusion vary from one in 250, 000 to one in
40, 000 units of blood. A Red Cross study reported in 1989 that
the risk was one in 153,000. The main reason for this risk is
that some recently infected people may give blood, not knowing
that they are infected. Currently used blood tests look for
antibodies to HIV. These tests may not be able to detect
antibodies in the blood of some recently infected people, even
though the blood contains HIV. However, HIV-infected people and
those at risk for HIV infection rarely donate, and HIV-infected
donations rarely slip through because of thorough donor
interviewing and blood testing.
If you know you will need blood — scheduled surgery, for
example — you can give blood for your own use. This is known as
SUBHEAD: What Happens to My Career If I'm Infected?
The time from when a person is infected with the HIV to the
appearance of clinical symptoms indicating that disease is
developing may be 10 years or longer. During this symptom- free
period, the HIV-infected person is fully functional and capable
of performing his or her assigned duties.
Navy policy states that personnel who are HIV-antibody
positive and found medically fit for duty shall be assigned
within the United States to a unit not normally programmed for
deployment and within 300 miles of a naval medical treatment
facility designated by the Navy Surgeon General. These
facilities are Naval Medical Centers Bethesda, MD, Oakland, CA,
Portsmouth, VA, and San Diego; Naval Hospitals Beaufort, SC,
Bremerton, WA, Camp Lejeune, NC, Camp Pendleton, CA, Charleston,
SC, Corpus Christ i, TX, Great Lakes, IL, Groton, CT,
Jacksonville, FL, Long Beach, CA, Millington, TN, Newport, RI,
Orlando, FL, and Pensacola, FL; and Naval Medical Clinic
Every effort is taken to maintain confidentiality of a
member's HIV status and to ensure continued career options.
Detailers have knowledge of the options available to service
members. Since HIV-infected personnel cannot be assigned to sea
duty or deployable units, junior enlisted members in
sea-intensive ratings (i.e., OS, BT, QM, etc.) may have to change
their rating to have a viable career. HIV-infected pilots, NFOs,
ACs and aircrew members are permanently grounded and reassigned
to shore duty. Outstanding performance is key for advancement of
all personnel, since personnel records cannot contain a member's
HIV status. HIV infection cannot be the sole reason to deny
HIV— infected personnel are medically retired from the
service when they become too sick to perform their job, usually
when the individual reaches stage three or four of infection,
which is characterized by a T-cell count of 300 or less and loss
of skin test sensitivity (delayed hypersensitivity) .
SUBHEAD: Be Smart, Not Scared
HIV is not transmitted by other means, such as touching or
casual contact, even on a repeated basis; it is not transmitted
by eating food prepared by an HIV-positive person; it is not
transmitted by insect bites.
HIV is transmitted by sexual contact (vaginal, anal or oral
intercourse); by parenteral contact (needle stick inoculation of
blood and fluid, transfusion of blood or blood products,
inoculation of blood or blood products into mucous membranes or
skin, needle sharing by injecting drug users) ; and by mother to
infant contact (during pregnancy, at the time of delivery, during
Know the facts and think before you act. You only have one
life, so choose behaviors that will protect you and those you
The Navy HIV Program located in Bethesda, MD, exists to
serve you — the men and women of the Navy and Marine Corps. If
you need information, or would like to become a Navy HIV
prevention instructor, call the staff at DSN 295-0048 or
commercial (301) 295-0048.
EDITORS NOTE: The Spring 1995 Captain's Call Kit contains a
short version of this article.
3. Two-month calendar of events, observances and anniversaries:
National Alcohol Awareness Month (212/206-6770)
Cancer Control Month (404/329-5739)
Child Abuse Prevention Month (312/663-3520)
Month of the Military Child
Stress Awareness Month
National Occupational Therapy Month (301/652-2682)
National Sexually Transmitted Disease (STD) Awareness Month
Sports Eye Safety Month (1-800-331-2020)
National Youth Sports Injury Prevention Month (617/449-2499)
National Humor Month (408/624-3058)
Mathematics Education Month
Keep America Beautiful Month
3 April - 1 May: Annual Savings Bonds Campaign
7 April: World Health Day
7-9 April: Alcohol-Free Weekend (212/206-6770)
9 April : Palm Sunday
9-15 April: National Building Safety Week (703/437-0100)
9-15 April: National Library Week "Libraries Change Lives"
(312/280-5044/1 or 1-800-545-2433, ext . 5044 or 5041)
11 April: Morning (0600-0800) and Night (until 2200)
Detailing (times are for Washington DC)
14 April: Good Friday
14-22 April: Passover (begins sundown/ends sundown)
1 6 April : Easter
16-22 April: National Organ/Tissue Donor Awareness Week
(804/330-8500; in IL, 312/431-3600)
16-22 April: National Medical Laboratory Week (312/738-
17 April: 0-5 Staff Corps selection board convenes
17 April: Deadline for filing Income Tax returns
18 April: National Youth Service Day
21 April 1945: Allies entered Berlin
22 April : Earth Day (25th Anniversary)
22-28 April: National Infant Immunization Week (404/639-
23-29 April: National Volunteer Week (202/223-9186, xl46)
24 April: Medical Enlisted Commissioning Program board
24-28 April: Electroneurodiagnostic (END) Technologists
25 April: Morning (0600-0800) and Night (until 2200)
Detailing (times are for Washington DC)
25 April 1945: United Nations organized
26 April : Professional Secretaries Day
27 April: Take Our Daughters To Work Day "A girl is
watching. What is she learning?"
27 April: Yom Hoshoah/Holocaust Remembrance Day
28 April : Arbor Day
29-30 April: March of Dimes WalkAmerica (914/997-4622)
30 April 1970: Vietnam War ends with fall of Saigon
30 April: E-9 Evals Due
Asian-Pacific Heritage Month
National Physical Fitness and Sports Month (202/272-3427)
National Arthritis Month (404/872-7100, ext. 6343)
National Asthma and Allergy Awareness Month (1-800-878-4403)
National Clean Air Month (American Lung Association
Better Hearing and Speech Month (301/897-5700)
National Sight-Saving Month (1-800-331-2020)
Better Sleep Month (703/683-8371)
Correct Posture Month (American Chiropractic Association, 1-
National Digestive Diseases Awareness Month (202/544-7497)
National High Blood Pressure Month (301/251-1222)
Huntington's Disease Awareness Month (1-800-345-HDSA or
National Melanoma/Skin Cancer Detection and Prevention Month
(Department of Communications , American Academy of Dermatology,
930 N. Meacham Rd., Schaumburg, IL 60173)
National Mental Health Month (703/684-7722)
National Neurofibromatosis Awareness Month (1-800-323-7938)
National Stroke Awareness Month (American Heart Association:
1-800-553-6321; National Stroke Association: 1-800-STROKES)
Older Americans Month (202/401-4541)
National Trauma Awareness Month (1-800-556-7890)
National Bike Month — "A Fun Way to Stay Healthy"
1 May, 0001: NDW shifts to summer uniform
1 May: Law Day USA
1-7 May: Public Service Recognition Week
4 May: National Day of Prayer
4 May - 6 June: 1995 Navy-Marine Corps Relief Society Fund
Drive — "Assisting Sailors, Marines and Their Families for 91
5 May 1847: American Medical Association began
6 May: Nurses Day
6-12 May: National Nurses Week (202-651-7021)
7-13 May: National Running and Fitness Week (301/913-9317)
7-13 May: National Hospital Week (916/552-7577)
7-13 May: Be Kind to Animals Week
8 May 1945: V-E Day
8-14 May: National Stuttering Awareness Week (1-800-922-
12 May: Military Spouse Day
12 May 1820: Florence Nightingale born
13 May 1908: Navy Nurse Corps Birthday
14 May: Mother's Day
14-20 May: Armed Forces Week — "Forces for Freedom"
14-20 May: National Emergency Medical Services Week
14-20 May: National Medical Transcriptionist Week (209/551-
14-20 May: National Nursing Home Week (202/842-4444)
14-20 May: National Osteoporosis Prevention Week (202/223-
15 May: Reserve 0-5/0-6 Staff Selection Board Convenes
17 May: National Employee Health and Fitness Day (312/237-
20 May: Armed Forces Day — "Forces for Freedom"
21-27 May: National Surgical Technologists Week (303/694-
22-28 May: National Park Week
25 May: National Missing Children's Day (914/255-1848)
29 May: Memorial Day Observed
30 May: Memorial Day
30 May: Muharram (Islamic New Year)
31 May: National Senior Health & Fitness Day (708/816-8660
31 May: World No Tobacco Day (World Health Organization,
31 May: ENS Fit Reps Due
4. ADDRESSEES ARE ENCOURAGED TO SUBMIT INFORMATION AND NEWS
ITEMS OF MEDICAL DEPARTMENT OR BENEFICIARY INTEREST (IN STORY
FORMAT) BY TELEPHONE, FAX OR E-MAIL TO BUMED, ATTN: EDITOR,
NAVAL SERVICE MEDICAL NEWS (MED 00P2) . TELEPHONE (202) 653-0793,
DSN 294-0793. FAX (202) 653-0086, DSN 294-0086. E-MAIL
NMCOENLQBUMEDl . MED . NAVY. MIL//